1/5. Improvements in artery occlusion by low-density lipoprotein apheresis in a patient with peripheral arterial disease.peripheral arterial disease (PAD; arteriosclerosis obliterans) shows ischemic symptoms along the peripheral arteries due to reduced blood flow, and the number of patients with PAD is increasing. Several papers have reported on the clinical effect of low-density lipoprotein apheresis (LDL-A) on PAD, but there has been no report so far on the improvement of total peripheral artery stenosis by LDL-A. We report on the clinical course of a female PAD patient with intractable decubitus in her heel due to the complete occlusion of anterior tibial artery who was treated by a series of LDL-A sessions. The complete occlusion of the anterior tibial artery improved as seen on angiography, and the decubitus in her heel also markedly improved after LDL-A therapy. This report supports the clinical benefit of LDL-A for the treatment of PAD.- - - - - - - - - - ranking = 1keywords = peripheral arterial disease, arterial disease, peripheral (Clic here for more details about this article) |
2/5. Percutaneous transluminal angioplasty against arteriosclerosis obliterans in dialysis patients.The incidence of peripheral arteriosclerosis is on the increase in chronic hemodialysis patients. Recently, the intervention (IV) treatment is conducted to deal with this problem. IV was performed in 4 dialysis patients against the complication of arteriosclerosis obliterans (ASO) but the result was unsuccessful in 3 of them. These 3 failure cases were investigated to find the problems associated with percutaneous transluminal angioplasty (PTA). Cases 1, 2 and 3 had intermittent claudication while case 4 had gangrenous toes as the major complaint. The symptoms in these cases were attributable to 90-100% stenosis and occlusion of superficial femoral artery, bilateral iliac arteries, bilateral superficial femoral-popliteal artery, branch of right iliac artery and left iliac artery region, respectively. IV was successful in case 1 but failed in cases 2 and 4 because the catheter itself did not go through due to the severe stenosis of vessel or the procedure of forcefully dilating the vessel caused dispersion of minute thrombi. In case 3, acute myocardial infarction occurred at 10 h after successful IV, resulting in sudden death. In view of the extent of invasion, IV is a treatment method selected against ASO in dialysis patients. However, the method has a high risk of causing thrombus formation, vessel rupture and organ failure. In this regard, it is advisable to evaluate the systemic condition and conduct IV if the extent of stenosis is mild.- - - - - - - - - - ranking = 3.7470799708204E-5keywords = peripheral (Clic here for more details about this article) |
3/5. Omental transplantation for chronic occlusive arterial diseases.Problems of surgical indication and technique for the treatment of chronic occlusive arterial diseases remain unresolved, especially in the cases which show poor angiogram run-off. To establish the surgical technique of omental transplantation, anatomical findings of the omental vessels were studied. The anatomical findings of the omentum were classified into two types. Type I (single layer) and Type II (double layer), and subdivided into seven subtypes according to the number of omental arterial branches. Omental transplantation was performed in our clinic in 19 cases (20 limbs) and surgical results were satisfactory. The examination of microscopic findings of the implanted omentum and the ischemic muscle of the implanted limb by consecutive serial sections suggested that the vessels of the omentum might invade the ischemic muscular tissue and supply blood to the muscle. Omental transplantation should be considered one of the most useful surgical techniques in cases with poor angiogram run-off.- - - - - - - - - - ranking = 0.15444863618492keywords = arterial disease (Clic here for more details about this article) |
4/5. thrombocytopenia and lupus-like anticoagulant in a patient with peripheral vascular disease: response to infusion of prostacyclin.A 46 year old man with intermittent claudication due to severe peripheral vascular disease had a circulating lupus like anticoagulant (LLAC), thrombocytopenia (79 X 109/1), markedly reduced platelet survival and a normal bone marrow. He was treated with intravenous prostacyclin (PGI2) infusions which resulted in improvement of the patient's exercise tolerance and normalisation of his platelet count (300 X 109/1) and platelet aggregation could then be assessed. The platelets were markedly hyperaggregable and generated supranormal quantities of thromboxane a2. A diagnosis of consumptive thrombocytopenia secondary to peripheral vascular disease and platelet hyperaggregability was made. Despite therapy with aspirin and dipyridamole, gradual and progressive reduction in platelet count followed and his exercise tolerance declined over the next three months. Immunoglobulin prepared from the patient's serum did not inhibit vascular PGI2 synthesis in vitro. To our knowledge this is the first reported case of consumptive thrombocytopenia due to severe peripheral vascular disease and platelet hyperaggregability. PGI2 administration caused a transient resolution of these features which was not sustained by aspirin and dipyridamole.- - - - - - - - - - ranking = 0.00026229559795743keywords = peripheral (Clic here for more details about this article) |
5/5. Patient assessment and examples of a method of treatment. Use of the circulator boot in peripheral vascular disease.Effective peripheral blood flow is positively related to cardiac output and gravity (part dependent) and inversely related to gravity (part elevated), venous pressure, interstitial fluid pressure, degree of peripheral neuropathy, arteriosclerotic and thrombotic arterial obstructions, and infection. These factors are considered in the operation of the end-diastolic pneumatic boot in the treatment of illustrative patients with lymphedema, venous stasis disease, peripheral arteriosclerosis obliterans, peripheral neuropathy, cellulitis, and osteomyelitis and the failing heart. A method of treatment that includes the use of the boot and the injection of local antibiotics is described.- - - - - - - - - - ranking = 0.00029976639766563keywords = peripheral (Clic here for more details about this article) |